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Form of appeal to the Appellate Tribunal

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..... TAN (if applicable) Complete address for sending Notices State Pin Code Phone No. with STD code/ Mobile No. (if available) Email Address (if available) Appeal Details 1 Assessment year in connection with which the appeal is Preferred 2 Total income declared by the assesse for the assessment year referred to in item 1 3 Details of the order appealed against a. Section and sub-section under which the order is passed b Date of order c Date of service or communication of the order 4 Income-tax Authority passing the order appealed against .....

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..... Signed Signed (Authorised representative, if any) (Appellant) Name: Name: Designation: Designation: Form of verification I,_____________, the appellant, do hereby declare that what is stated above is true to the best of my information and belief. Place Date Signature Name: Designation: Notes: 1. The memorandum of appeal shall be in triplicate and shall be accompanied by- (a) two copies (at least one of which should be a certified copy) of the order appealed against, two copies of the relevant order of the Assessing Officer, two copies of the grounds of appeal or the grounds of objection before the first appellate authority or the Dispute Resolution Panel, two copies of the statement of facts, if any, filed before the said appellate authority or the Dispute Resolution Panel, and also- (i) in the case of an appeal against an order levying penalty, two copies of the relevant assessment order; (ii) i .....

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..... ten in English or, if the appeal is filed in a Bench located in any State notified by the President of the Appellate Tribunal for the purposes of rule 5A of the Income-tax (Appellate Tribunal) Rules, 1963, then, at the option of the appellant, in Hindi, and shall set forth, concisely and under distinct heads, the grounds of appeal without any argument or narrative and such grounds should be numbered consecutively. 4. The Appeal number and year of appeal shall be filled in by the office of the Appellate Tribunal. 5. In column s seeking Appellant s and Respondent s information, the relevant data, as applicable shall be filled in properly. Illustration. __ for instance in case the Department is Appellant or Respondent, as the case may be, the designation of the officer filing the Appeal and details pertaining to his office may be filled, if available. 6. The 'Tax effect' for the purpose of filling this Form shall be taken as the difference between the tax on the total income assessed and the tax that would have been chargeable had such total income been reduced by the amount of income in respect of the issues against which appeal is intended to be filed (i.e .....

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..... . .. *Appeal No. . Of .. 20 . -20 Appellant..................... Versus Respondent.................................. 1. The State in which the assessment was made 2. Section under which the order appealed against was passed 3. **Assessment year in connection with which the appeal is preferred 3A. Total income declared by the assessee for the assessment year referred to in item 3 3B. Total income as computed by the Assessing Officer for the assessment year referred to in item 3 4. ***The Assessing Officer passing the original order 5. ****Section of the Income-tax Act, 1961, under which the Assessing Officer passed the order 6. The Deputy Commissioner (Appeals) in respect of orders passed before the 1st day of October, 1998 /Commissioner (Appeals) passing the order under section 154/250/271/271A/272A 7. The Deputy Commissioner or the Deputy Director in respect of orders passed before the 1st day of October .....

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..... Officer, in the case to which the appeal relates, is one hundred thousand rupees or less, five hundred rupees; (b) Where the total income of the assessee, computed as aforesaid, in the case to which the appeal relates is more than one hundred thousand rupees but not more than two hundred thousand rupees, one thousand five hundred thousand rupees; (c) Where the total income of the assessee, computed as aforesaid, in the case to which the appeal relates is more than two hundred thousand rupees, one per cent of the assessed income, subject to a maximum of ten thousand rupees; (d) no fee shall be payable in the case of a memorandum of cross-objections; (e) an application for stay of demand shall be accompanied by a fee of five hundred rupees. It is suggested that the fee should be credited in a branch of the authorised bank or a branch of the State Bank of India or a branch of the Reserve Bank of India after obtaining a challan and the triplicate challan sent to the Appellant Tribunal with a memorandum of appeal. The Appellate Tribunal will not accept cheques, drafts, hundies or other negotiable instruments. 3. The memorandum of appeal should be written in English o .....

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